EXPRESS:肺炎相关急性呼吸窘迫综合征患者支气管肺泡灌洗液和血清中特异性免疫血栓生物标志物谱的比较分析:初步横断面研究。

IF 2.5 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Journal of Investigative Medicine Pub Date : 2025-01-01 Epub Date: 2024-10-27 DOI:10.1177/10815589241288515
Xiaolong Zong, Xuechao Wang, Yaru Liu, Xiao Wang, Duanyang Li, Zhiqing Zhou, Zhenyu Li
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引用次数: 0

摘要

免疫血栓已成为急性呼吸窘迫综合征(ARDS)发生和发展的潜在机理环节,但人们对其在患者局部和全身的具体表现了解有限。本研究旨在描述和比较确诊为肺炎相关 ARDS(p-ARDS)患者的肺部和全身免疫血栓特征,并评估其临床相关性。研究对象包括 2022 年 7 月至 2023 年 5 月期间在一家三级甲等大学医院重症监护室住院的 23 名连续确诊为肺炎相关 ARDS 患者,以及 40 名同时住院的普通肺炎患者作为对照。研究人员收集了成对的支气管肺泡灌洗液(BALF)和血清样本,分析了15种生物标记物,以评估和量化肺部和全身免疫血栓特征。研究结果显示,与肺炎对照组相比,p-ARDS 患者的肺部炎症和全身内皮损伤明显。在对病情严重程度(急性生理学和慢性健康评估[APACHE] II评分)进行调整后,这些观察结果仍保持不变。在临床相关性方面,研究发现 BALF 中的炎症生物标志物(白细胞介素 [IL]-6、IL-8)与 PaO2/FiO2 比率相关,而血清中的 ADAMTS-13 和血栓调节蛋白 (TM) 水平与序贯器官衰竭评估 (SOFA) 和弥散性血管内凝血 (DIC) 评分相关。总之,这项初步调查确定了 p-ARDS 患者与单纯肺炎患者之间免疫血栓特征的区段特异性差异,炎症反应主要发生在肺泡区段,而凝血/内皮损伤生物标志物在外周血中更为明显。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative analysis of compartment-specific immunothrombotic biomarker profiles in bronchoalveolar lavage fluid and serum of patients with pneumonia-related acute respiratory distress syndrome: A preliminary cross-sectional study.

Immunothrombosis has emerged as a potential mechanistic link underlying the development and progression of acute respiratory distress syndrome (ARDS), but understanding its specific profile in patients, both locally and systemically, is limited. The objective of this study was to characterize and compare the immunothrombotic signatures in patients diagnosed with pneumonia-related ARDS (p-ARDS) at both the pulmonary and systemic levels and to evaluate their clinical relevance. The study included 23 consecutive patients diagnosed with p-ARDS admitted to the intensive care unit at a tertiary university hospital from July 2022 to May 2023, alongside 40 concurrently hospitalized patients with common pneumonia as controls. Paired bronchoalveolar lavage fluid (BALF) and serum samples were collected from the participants for the analysis of 15 biomarkers to assess and quantify the pulmonary and systemic immunothrombotic signatures. The study results revealed significant pulmonary inflammation and systemic endothelial injury in p-ARDS patients compared to pneumonia controls. These observations were maintained after adjustment for severity of illness (Acute Physiology and Chronic Health Evaluation II scores). In terms of clinical relevance, inflammatory biomarkers (interleukin [IL]-6, IL-8) in BALF were found to correlate with PaO2/FiO2 ratio, while serum levels of a disintegrin and metalloproteinase with thrombospondin type 1 motif 13 (ADAMTS-13) and thrombomodulin showed associations with Sequential Organ Failure Assessment and Disseminated Intravascular Coagulation scores. In conclusion, this preliminary investigation identified compartment-specific variations in the immunothrombotic signature between patients with p-ARDS and those with pneumonia alone, with inflammatory responses predominantly localized in the alveolar compartments and coagulation/endothelial injury biomarkers more pronounced in peripheral blood.

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来源期刊
Journal of Investigative Medicine
Journal of Investigative Medicine 医学-医学:内科
CiteScore
4.90
自引率
0.00%
发文量
111
审稿时长
24 months
期刊介绍: Journal of Investigative Medicine (JIM) is the official publication of the American Federation for Medical Research. The journal is peer-reviewed and publishes high-quality original articles and reviews in the areas of basic, clinical, and translational medical research. JIM publishes on all topics and specialty areas that are critical to the conduct of the entire spectrum of biomedical research: from the translation of clinical observations at the bedside, to basic and animal research to clinical research and the implementation of innovative medical care.
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